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Individual

RYAN JOSEPH ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
545 BARNHILL DR, INDIANAPOLIS, IN 46202-5112
(317) 944-6049
Mailing address
545 BARNHILL DR, INDIANAPOLIS, IN 46202-5112
(317) 944-6049

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01090515A
IN
2086X0206X
Surgical Oncology Physician
Primary
01090515A
IN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1103151909
ANTHEM PTAN
IN
05
300079050
IN
Enumeration date
03/29/2014
Last updated
02/19/2025
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